Chinese Census Research Articles

Prevalence of Elevated Alanine Aminotransferase by Diagnostic Criterion, Age, and Gender among Adolescents.

Background Serum alanine aminotransferase (ALT) activity was measured not only to detect liver disease, but also to monitor overall health. The purpose of this study was to obtain the prevalence of elevated ALT levels among adolescents. Methods In a school-based cross-sectional study, a representative sample was analyzed from 9 middle and high schools in Shenzhen, China, during 2017 to 2018. Elevated ALT was defined as diagnostic criterion I (>30 U/L for boys and >19 U/L for girls) and diagnostic criterion II (>40 U/L). Results From the adolescent population, a total of 7281 students (boys, 4014, and girls, 3267) aged from 10 to 17 years were collected. The prevalence of elevated ALT was 7.11% (6.88% for boys and 7.41% for girls) by criterion I and 2.72% (3.96% for boys and 1.19% for girls) by criterion II. Based on the Shenzhen census and Chinese national census population, the adjusted prevalence of elevated ALT was 7.65% (boys 7.19% and girls 8.21%) and 6.79% (boys 6.07% and girls 7.56%) by criterion I and 2.85% (boys 4.20% and girls 1.16%) and 2.43% (boys 3.49% and girls 1.29%) by criterion II. For age, the overall trends were increasing progressively, regardless of the use of diagnostic criteria for an elevated ALT activity. Conclusions This study supplements the gap that the prevalence of elevated ALT levels differed in gender, age, and criteria among adolescents of Shenzhen. We should take the prevalence as a predictor and continue to play a warning and preventive role in preparation for further intervention.

Prevalence and Influencing Factors of Coronary Heart Disease and Stroke in Chinese Rural Adults: The Henan Rural Cohort Study.

Background: Epidemiological studies about cardiovascular disease in rural areas of developing countries are rare. This study aimed to estimate the prevalence and influencing factors of coronary heart disease (CHD) and stroke in Chinese rural population.Methods: 39,259 subjects (15,490 males) aged 18–79 years were enrolled from the Henan Rural Cohort Study. Age-standardized prevalence was calculated according to Chinese 6th Population Census. Associations between risk factors and diseases were estimated by the odds ratios and 95% confidence intervals with generalized linear mixed model.Results: Among the participants, 1,734 with CHD and 2,642 with stroke were identified. Crude prevalence of CHD was 4.42%, and prevalence in male (4.01%) was significantly lower than female (4.68%). Corresponding age-standardized prevalence was 2.23% (2.05% for male and 2.37% for female). Crude prevalence of stroke was 6.73%, and in male (7.92%) was higher than female (5.95%). Age-standardized prevalence was 2.98% (3.42% for male and 2.69% for female). The results identified that old age, female, smoking, obesity, hypertension, diabetes, and dyslipidemia were positively associated with CHD. Being Female and a higher level of physical activity were negatively related to stroke, while old age, high-risk drinking, and chronic disease were positively related to stroke.Conclusion: CHD and stroke were not rare in Chinese rural area. Healthy lifestyles and control of chronic disease should be improved to curb the epidemic of cardiovascular disease among rural population.Clinical Trial Registration: The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). http://www.chictr.org.cn/showproj.aspx?proj=11375.

The fourth Chinese economic census: assessment of the state of the national economy

The fourth Chinese economic census, conducted in 2019, played an important role in identifying the economic potential, problems and prospects for the development of the national economy at the final stage of the 13th five-year plan (2016–2020).The base time for the census was December 31, 2018. The census covered all entities with the status of a legal entity operating on the territory of China, in the secondary and tertiary sectors of the economy — in industry, construction and numerous service industries, and subordinate production and economic structures and organizations, as well as individual farms registered as physical entities, in 31 regions of the country.One of the main places in the census is devoted to the analysis of the current state of private and individual enterprises, which make up the vast majority in the secondary and tertiary sectors of the economy. As a separate subject of research, medium-sized, small and micro-enterprises with the status of a legal entity, as well as individual farms are identified. Their priority importance in ensuring high-quality and sustainable development of the country, expanding employment channels, and improving the material well-being of citizens is shown.

The trends of mortality and years of life lost of cancers in urban and rural areas in China, 1990-2017.

BackgroundWith the rapid development of the socioeconomic status, the mortality of several cancers has been changed in China during the past 30 years. We aimed to estimate the trends of mortality and years of life lost (YLLs) of various cancers in urban and rural areas of China from 1990 to 2017.MethodsThe mortality data were collected from Chinese yearbooks and the age structure of population from the Chinese sixth population census were used as reference to calculate age‐standardized mortality rates (ASMRs) and YLLs rates. Joinpoint regression analysis was implemented to calculate the annual percent change (APC) of mortality rates and YLL rates for cancers. YLLs owing to premature death were calculated as age‐specific cancer deaths multiplied by the reference life expectancy at birth of 80 years for male and 82.5 years for female.ResultsThe ASMRs of all cancers showed significant decreasing trends for urban residents from 1990 to 2017, such downward trend without significance was also observed among rural residents. Interestingly, ASMRs of lung cancer and breast cancer have raised continuously in rural areas since 1990. The age‐standardized YYL rates for urban and rural residents decreased with 1.02% and 0.85% per year, respectively. YLLs in rural areas were higher than those in urban areas, whereas YLLs of urban outstripped those of rural finally with the increasing in YLLs of urban areas (216.71% for men and 207.87% for women).ConclusionThe ASMRs and YLL rates of all cancers have declined in urban and rural areas from 1990 to 2017. YLLs increased in urban areas and remained higher level in rural areas after 2014 year. Preventive measures should be strengthened to against cancer, especially for lung cancer.

PREDICTION OF THE NUMBER OF AND CARE COSTS FOR DISABLED OLDER ADULTS FROM 2020 TO 2050 IN URBAN AND RURAL AREAS IN CHINA

Disability for the elderly has become a crucial policy concerns in rapidly aging Asia counties, especially in China. This study aimed to predict the trend of the number of and care costs for disabled older adults from 2020 to 2050 in urban and rural areas in China. Population Administration Decision Information System was used to predict the population of China by urban and rural areas and age group from 2020 to 2050. Monte Carlo simulation and Policy Simulation Model were used to estimate the number and care costs of disabled elderly between urban and rural areas, based on the Chinese latest census data, statistical yearbook, and national survey database. The total disabled population rises rapidly from 43.75 million in 2020 to 91.4 million in 2050, of which 69.7% were urban adults. Compared with the values in 2020, the growth rates of the adults with mild, moderate and severe disabilities were 108%, 104% and 120% in 2050, respectively. The value were 167% and 39% in urban and rural areas, respectively. By 2050, the total care costs increase from 538.0 billion yuan in 2020 to 8530.8 billion yuan, of which 80.2% occurs in urban areas. The predicted results indicate that the numbers and care costs for disabled older adults increase sharply from 2020 to 2050, especially in urban areas of China. It provided a series of evidence for the establishment of the long-term care insurance system in China.

Incidence and mortality of thyroid cancer in cancer registries of Zhejiang Province, 2010-2014

From 2010 to 2014, a total of 17 150 new cases of thyroid cancer (TC) reported in cancer registration areas of Zhejiang province, the crude incidence rate of TC was 29.28/100 000. Using the Chinese Census in 2000 and the World Segi's population as the standard population, the age-standardized incidence rate by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 24.11/100 000 and 20.65/100 000 respectively. 256 TC death cases reported in all, the crude mortality rate was 0.44/100 000, the age-standardized mortality rate by Chinese standard population (ASMRC) and by World standard population (ASMRW) were 0.23/100 000 and 0.23/100 000 respectively. The ASIRC had a upward trend [annual percent change (APC)=28.62%, 95%CI: 21.00%-36.72%, t=13.10, P=0.001], while the ASMRC trend seemed stable (APC=0.73%, 95%CI: -7.47%-9.66%, t=0.27, P=0.803).

Question of ethnic group formulation in the Chinese census

In conjunction with official government information and existing research literature, this article discusses ethnic group formulation in the censuses of China since 1953. Followed by an examination of concept of “ethnicity”, the research explores the purpose of the question included in the census, ways to answer the census question, and changes in number of official ethnic groups finalized until 1980s in China. To make a good study on ethnicity by census statistics, we have to understand the system of census taking on ethnicity in different countries. As a country with different minority groups, China is undergoing a social transformation and improving its census-taking. Ethnicity-related information collected in the census will play a more important role in the development of Chinese society.

Is banning sex-selection the best approach for reducing prenatal discrimination?

ABSTRACTPressure to ban prenatal sex-selection has grown with rising sex ratios at birth in some countries. Governments feel pressured to act, and bans seem an immediate step they can take. However, such bans have been in place for some time in South Korea, China, and India and the available evidence suggests they are difficult to implement and have limited impact. This is indicated most clearly in the Chinese census data, which throw light on the mixed effects of a very intensive effort to implement the ban. Studies show that bans on sex-selection have negative consequences for unwanted girls and their mothers. By contrast, other studies have shown that other policies – including mass messaging and measures to increase gender equity – show fairly quick impact in reducing son preference and increasing parental investment in girls. Such policies can permanently lower son preference and sex-selection, while also improving girls’ life-chances.

Geographic inequality and ethnic stratification in China, 2000 to 2010

PurposeThe purpose of this paper is to extend current knowledge by focusing on three geographic factors (minority-Han residential segregation, rural-urban disparities and regional differences) and their effects on educational and occupational outcomes of Chinese ethnic minorities from 2000 to 2010.Design/methodology/approachData from the 2000 and 2010 Chinese decennial censuses were used, and both descriptive and multivariate analyses were conducted.FindingsResults revel that there were regional differences in terms of educational segregation between minorities and the Han. It was also difficult for minority groups that were residentially segregated from the Han and mainly located in rural areas or western/southeastern regions to obtain high-level education. When minority groups were residentially segregated from the Han, they tended to have higher levels of occupational segregation from the Han; while minority groups with larger percentages of rural residents tended to have smaller percentages of people obtained high-status occupations. Despite China’s rapid social and economic development, ethnic disparities in education did not significantly change, and ethnic gaps in occupational attainment were widened from 2000 to 2010.Social implicationsGeographic sources of ethnic conflicts in China should not be overlooked, and future researchers should also conduct studies on Chinese ethnic minorities at individual or household level.Originality/valueThis study contributes to the literature in two major ways: first, all Chinese minority groups were included in the analyses to clarify intra-ethnic differences; second, data from two Chinese decennial censuses and longitudinal statistical modeling were used to investigate the effect of time on ethnic stratification.

The major causes and risk factors of total and cause-specific mortality during 5.4-year follow-up: the Shanghai Changfeng Study

To investigate the major causes and predictive factors of death in a middle-aged and elderly Chinese population. A total of 6591 residents aged ≥ 45 years from Shanghai Changfeng community were followed up for an average of 5.4 years. The causes of death were coded according to the 10th Revision of International Classification of Diseases. The mortality rate was calculated by person-years of follow up and age-standardized according to the 2010 Chinese census data. Multivariable-adjusted Cox proportional hazards model was performed to investigate the predictors of all-cause and cause-specific mortality. During the total follow-up of 35,739 person-years, 370 deaths were documented (157 from malignant neoplasms, 70 from heart diseases, 68 from cerebrovascular diseases, 75 from other causes). The age-standardized all-cause mortality rate was 798.2 per 100,000 person-years (927.9 among men and 716.7 among women). Results from multivariable analyses showed that aging, diabetes, and osteoporosis at baseline were independent predictors of all-cause mortality, with hazard ratios (HR) of 1.11 (95% CI 1.10–1.13), 1.91 (1.51–2.42), and 1.71 (1.24–2.35), respectively. The population attributable risk percent of diabetes and osteoporosis was 19.7% and 11.7%, respectively. Cigarette smoking was associated with a higher risk of all-cause mortality in men (HR and 95%CI 1.44, 1.01–2.06). In women, diabetes and osteoporosis were related to a higher risk of cardiovascular mortality (3.27, 1.82–5.88 and 1.89, 1.04–3.46, respectively). While in men, osteoporosis was related to a higher risk of malignant neoplasms mortality (2.39, 1.07–5.33). Malignant neoplasms, heart diseases, and cerebrovascular diseases are the leading causes of death. Aging, smoking, underweight, diabetes, and osteoporosis are independent predictors of premature death among middle-aged and elderly Chinese community population. Moreover, there may have been some differences in the causes and predictors of premature death between men and women.

National trend of gastric cancer mortality in China (2003\u20132015): a population-based study

BackgroundGastric cancer mortality decreased substantially over the last decades in most countries worldwide. This study aimed to assess the most recent national trend of gastric cancer mortality and examine the disparity of gastric cancer mortality between rural and urban areas in China.MethodsThe crude mortality data of gastric cancer by sex, age group, and area were obtained from China Health Statistical Yearbooks (2003–2015) covering 10% of Chinese population. The age-standardized rates of mortality (ASRM) of gastric cancer in rural and urban areas were estimated using the 2010 Chinese Census population stratified by age, sex, and area. The trend of mortality of gastric cancer was assessed by using Joinpoint analysis.ResultsDuring the 13-year period, the ASRM was reduced from 31.5/100,000 in 2003 to 20.9/100,000 in 2015 in rural areas and from 18.9/100,000 in 2003 to 14.5/100,000 in 2015 in urban areas. In the male population, the annual percent changes of mortality were − 2.2% in urban areas (95% confidence interval [CI] − 3.8% to − 0.6%; P < 0.001) and − 3.4% in rural areas (95% CI − 5.1% to − 1.8%; P < 0.001). In the female population, the annual percent changes of mortality were − 2.7% in urban areas (95% CI − 4.2% to − 1.2%; P < 0.001) and − 4.6% in rural areas (95% CI − 5.5% to − 3.7%; P < 0.001).ConclusionsThe declining trend of mortality of gastric cancer was presented from 2003 to 2015 in both rural and urban areas in China. The decrease in gastric cancer mortality is greater in rural areas than in urban areas in China.

Report of breast cancer incidence and mortality in China registry regions, 2008-2012

Objective: The registration data of local cancer registries from 2008 to 2012 were collected by National Central Cancer Registry to estimate the incidence and mortality of female breast cancer in China. Methods: Data from 135 registries were qualified and selected in the final analysis, and each registry at least has submitted data from 2010 to 2012. Cancer incidence and mortality analyses were stratified by area (urban/rural, eastern/middle/western areas) and age group. The age composition of standard population of Chinese census in 2000 and Segi's population were used for age-standardized incidence and mortality in China and worldwide, respectively. Results: A total of 135 registries were recruited in the analysis, covering 629 333 910 person-years (382 669 450 in urban and 246 664 460 in rural). About 13, 258 cases of female breast cancer were diagnosed and 32 205 cases were dead between 2008 and 2012. Female breast cancer incidence was 42.67/100, 000 and age-standardized rate calculated by worldwide standard population was 28.87/100, 000. The crude incidence of urban area was 51.85/100, 000, higher than 28.29/100, 000 of rural area, and the crude incidence of eastern area was 46.35/100, 000, higher than 36.38/100, 000 of middle area and 27.60/100, 000 of western area. The age-specific incidence increased with age and reached the peak at age 55-59 (96.36/100, 000), and declined at age 60. The age-standardized incidence rate by Chinese standard population increased 30.56% from 2003 to 2012. The increase rate of rural area was 72.32%, faster than 23.48% of urban area. Female breast cancer mortality was 10.36/100, 000 and the age-standardized rate calculated by worldwide standard population was 6.61/100, 000. The crude mortality of urban area was 11.64/100, 000, higher than 8.36/100, 000 of rural area, and the crude mortality of eastern area was 10.81/100, 000, higher than 7.38/100, 000 of middle area and 9.90/100, 000 of western area. The age-specific incidence increased with age and reached the peak at age above 85 (61.25/100, 000). Age-standardized incidence rate by Chinese standard population remained stable during the period of 2003-2012 (6.23%). The mortality rate mainly increased in rural area (54.94%), while decreased 2.32% in urban area over the 10 years. Conclusions: Although the incidence and mortality of breast cancer in China are comparatively low worldwide, in China the incidence and mortality of female breast cancer have rose to the first and sixth place respectively among all the female cancers. The disease burden of breast cancer is very different between urban and rural area. Therefore, the targeted measure and strategy of control and prevention according to the area difference are needed.

Report of incidence and mortality of gallbladder cancer in China, 2014

Objective: The incidence and mortality of gallbladder cancer from Chinese cancer registries in 2014 were analyzed to describe the prevalence of gallbladder cancer in China. Methods: Incidence and mortality data of gallbladder cancer in 2014 derived from registration data in 2017, collected by the National Central Cancer Registry (NCCR). Qualified data from 339 cancer registries were calculated after evaluating. According to the national population data of 2014, the gallbladder cancer incidence and mortality of China in 2014 were stratified by the area, gender and age.The age composition of standard population of Chinese census in 2000 and Segi's population were used for age-standardizes incidence and mortality in China and worldwide. Results: 339 cancer registries cover a total of 288 243 347 population including 146 203 891 males and 142 039 456 females (144 061 915 in urban and 144 181 432 in rural areas). The mortality to incidence ratio of gallbladder cancer was 0.74. The morphologically verified cases (MV%) and death certificate-only cases (DCO%) were 48.38% and 2.66%, respectively. Unclear diagnosis cases (UB%) was 0.48%. The crude incidence of gallbladder cancer in China in 2014 was 3.82/100 000, which accounted for 1.37% of new cancer cases (4.48/100 000 in urban areas and 3.01/100 000 in rural areas, 3.59/100 000 for male and 4.05/100 000 for female). Age-standardized incidence rates by Chinese standard population (ASR China) and world standard population (ASR world) were 2.38/100 000 and 2.37/100 000, respectively, and the cumulative incidence rate (0-74 age years old) was 0.27%.Besides, the crude mortality of gallbladder cancer was 2.86/100 000 (3.47/100 000 in urban areas and 2.12/100 000 in rural areas, 2.59/100 000 for male and 3.14/100 000 for female). Age-standardized mortality rates by ASR China and ASR world were 1.72/100 000 and 1.71/100 000, with a cumulative mortality rate (0-74 age years old) of 0.19%. Conclusion: The incidence and mortality of gallbladder cancer were significantly different between the city and country, while not obviously different between the female and male.

The incidence and mortality of lung cancer in China, 2014

Objective: To estimate lung cancer incidence and mortality in China using population-based cancer registry data in 2014 collected by National Central Cancer Registry of China (NCCRC). Methods: 449 cancer registries submitted cancer registry data in 2014. All datasets were evaluated and 339 registries' data which met the quality control criteria of NCCRC were analyzed. Numbers of new lung cancer cases and deaths were estimated using calculated incidence and mortality rates and corresponding national population stratified by areas, sexes and age groups. The standard population of Chinese census in 2000 and world Segi' s population were applied to calculate age-standardized incidence and mortality rates in China and worldwide, respectively. Results: A total of 781, 500 new lung cancer cases were diagnosed in 2014. The crude incidence rate was 57.13 per 100 000 and the age-standardized incidence rates by Chinese standard population (ASIRC) and by world standard population (ASIRW) were 36.71 per 100 000 and 36.63 per 100 000, respectively. The cumulative incidence rate (0-74 years old) was 4.50%. Lung cancer was the most common cancer in male (ASIRW: 50.04 per 100 000) and the second most common cancer in female (ASIRW: 23.63 per 100 000). The incidence rates were slightly similar in urban areas and in rural areas (ASIRW: 36.64 per 100 000 vs 36.56 per 100 000). A total of 626 400 lung cancer deaths were reported. The crude mortality rate was 45.80 per 100 000 and the age-standardized mortality rates by Chinese standard population (ASMRC) and by world standard population (ASMRW) were 28.49 per 100 000 and 28.31 per 100 000, respectively. The cumulative mortality rate (0-74 years old) was 3.32%. Lung cancer was the most common cause of cancer deaths both in male (ASMRW: 40.21 per 100 000) and female (ASMRW: 16.88 per 100 000). The mortality rate was slightly higher in rural areas than in urban areas (ASMRW: 28.63 per 100 000 vs 28.04 per 100 000). Both lung cancer incidence and mortality rates increased with age, and the peak age was 80-84 years group. Conclusions: The disease burden of lung cancer is heavy in China. Efficient national health policies and prevention and control strategies against lung cancer should be promoted.

Use of the average age ratio method in analyzing age heaping in censuses: The case of China

Based on the methods of the average period age ratio and the average cohort age ratio, this study systematically assesses age heaping or digit preference in all population censuses of China. Our study finds that the overall age heaping was relatively low in the Chinese censuses; however, there was a notable preference for ages ending with zero after age 50 in the first two censuses, despite a weakening trend over time. Our study further shows that age heaping in China’s censuses is likely associated with age-related policies such as those on late marriage and retirement. As shown in the study, the average age ratio method can be an alternative of the Whipple’s Index and be improved if the size of birth cohort was taken into account when the number of births is generally reliable.

Using an introduced index to assess the association between food diversity and metabolic syndrome and its components in Chinese adults

BackgroundIt is reported that an increase in food diversity would lower the risk of cardiac–cerebral vascular diseases.MethodsA new index was introduced to develop a Chinese healthy food diversity (HFD) index, exploring the association with metabolic syndrome (MetS) and its components among Chinese adults. Two sets of data were used. The primary data were from a cross-sectional survey conducted in 2016 called the Chinese Urban Adults Diet and Health Study (CUADHS); the verification data were from the China Health and Nutrition Survey (CHNS) of 2009. The Chinese HFD index was developed according to the Chinese Dietary Guideline, with food consumption information from 24-h dietary recalls. The association between the index and MetS and its components was explored in logistic regression models.ResultsAmong 1520 participants in the CUADHS, the crude prevalence of MetS was 36.4%, which was 29.0% after the standardisation of age and gender by the 2010 Chinese national census. In the CUADHS, the HFD index ranged from 0.04 to 0.63. The value of the index among participants who are male, young, poorly educated, drinking or smoking, and with high energy intakes was significantly lower than that of their counterparts. In the verification dataset of the CHNS, there were 2398 participants, and the distribution of different genders and age groups was more balanced. The crude prevalence of MetS in the CHNS was 27.3% and the standardised prevalence was 19.5%. The Chinese HFD index ranged from 0.02 to 0.62. In the CUADHS, the Chinese HFD index was not significantly associated with MetS in covariate-adjusted models or with its components. In the CHNS, the Chinese HFD index had a significantly negative correlation with MetS and its components (i.e., elevated fasting glucose and elevated waist circumference) in covariate-adjusted models.ConclusionsIncreased food diversity may decrease the risk of MetS, which is important in dietary interventions of cardiac–cerebral vascular disease. This underscores the necessity of continued investigation into the role of HFD in the prevention of MetS and provides an integral framework for ongoing research.

Secular trends in mortality and causes of death among children and adolescents aged 1–19 years in China from 1953 to 2016: a national and subnational variations systematic analysis

BackgroundThe level and pace of mortality, and causes of death in children and adolescents might vary across regions within China. We aimed to analyse the national and subnational mortality trends, and the principal causes of deaths among Chinese children and adolescents aged 1–19 years from 1953 to 2016. MethodsData were drawn from the Global Burden of Disease study, Chinese Population Census, and China Health Statistics Yearbooks. National mortalities from 1953 to 2016 and subnational mortalities from 1981 to 2010 were calculated on the basis of data from the Chinese Population Census and China Health Statistics Yearbooks. The causes of deaths were taken from the Global Burden of Disease data for 1990 to 2016. FindingsMortality of Chinese children and adolescents aged 1–19 years declined steadily from 1953 to 2016, and there was a marked decline in mortality rates in children aged 1– 4 years during this period. Large subnational disparities in mortality (from all causes) existed across the 31 provinces, with higher mortality in western regions (eg, Xinjiang, Guizhou, and Yunnan). and lower mortality in eastern regions (eg, Beijing, Tianjin, and Hebei), but this gap narrowed with time from 1981 to 2010 (the period for which regional data were available). Injuries caused the highest number of deaths in children and adolescents (aged 1–19 years) each year from 1990 to 2016. Until 2016, the three factors that caused the highest numbers of deaths were road injuries (8·22 per 100 000 people), drowning (8·07 per 100 000 people), and congenital birth defects (3·22 per 100 000 people), but in 1990, they were drowning (31·21 per 100 000 people), lower respiratory infection (18·00 per 100 000 people), and road injuries (15·91 per 100 000 people). Drowning caused the most mortality in boys and in children aged 1–14 years, and road injury caused the most mortality in girls and in adolescents aged 15–19 years in 2016. InterpretationRemarkable improvements in the mortality rates of Chinese children and adolescents were observed from 1953 to 2016. There was also a reduction in the large subnational differences in mortality rates for this group in China, nevertheless disparities were still present in 2010. Our findings emphasise the need to strengthen measures to reduce the occurrence and severity of injuries, to establish subnational health systems across the nation, and to further reduce the subnational disparity in mortality rates across the provinces of China. FundingThe study was supported by the National Natural Science Foundation to JM (81673192).

Trends of Visual Impairment and Blindness in the Singapore Chinese Population over a Decade

We evaluated the prevalence of visual impairment (VI) and blindness among Chinese adults in the Singapore Chinese Eye Study (SCES, 2009–2011), and compared the trends with the Tanjong Pagar Survey, Singapore (TPS), conducted a decade earlier. The SCES comprised of 3,353 Chinese adults aged ≥40 years (response rate, 72.8%). Participants underwent standardized examinations, including measurements of presenting, and best-corrected visual acuity (VA). Bilateral VI (VA < 20/40 to ≥20/200) and blindness (VA < 20/200) were defined based on the United States definition (better-seeing eye). Age-standardized prevalence was calculated using the 2010 Singapore Chinese Population Census. Primary causes and factors associated with VI and blindness were evaluated. In SCES, the age-standardized prevalence of presenting bilateral VI and blindness were 17.7% and 0.6%, respectively; the age-standardised prevalence of best-corrected bilateral VI and blindness were 3.4% and 0.2%, respectively. The previous TPS reported similar rates of best-corrected bilateral VI (3.8%) and blindness (0.3%). In SCES, cataract remains the main cause for both best-corrected bilateral VI (76.0%) and blindness (50.0%). Older age, female, lower income, lower educational level, and smaller housing type were associated with presenting bilateral VI or blindness (all P ≤ 0.025). These findings will be useful for the planning of eye care services and resource allocation.

Significant variations in the cervical cancer screening rate in China by individual-level and geographical measures of socioeconomic status: a multilevel model analysis of a nationally representative survey dataset.

Variations in cervical cancer screening rates in China have rarely been studied in depth. This study aimed to investigate cervical cancer screening rates in relation to both individual‐level and geographical measures of socioeconomic status (SES). Data were obtained from women aged 21 years or older by face‐to‐face interviews between August 2013 and July 2014 as part of the Chinese Chronic Diseases and Risk Factors Surveillance. The geographical variables were obtained from the 2010 Chinese population census. The cervical cancer screening rates and 95% confidence interval (CI) were estimated and mapped. Multilevel logistic regression models were fitted. Overall, only 21.4% (95% CI: 19.6–23.1%) of 91,816 women aged ≥21 years reported having ever been screened for cervical cancer and significant geographical variations at both province and county levels were identified (P < 0.01). The cervical cancer screening rates were the lowest among the poor [13.9% (95% CI: 12.1–15.7%)], uninsured [14.4% (95% CI: 10.3–18.4%)], less‐educated [16.0% (95% CI: 14.3–17.6%)], and agricultural employment [18.1% (95% CI: 15.8–20.4%)] women along with those residing in areas of low economic status [15.0% (95% CI: 11.8–18.2%)], of low urbanization [15.6% (95% CI: 13.4–17.7%)], and of low education status [16.0% (95% CI: 14.0–18.1%)]. The multilevel analysis also indicated that women with lower individual‐level measures of SES residing in areas with low geographical measures of SES were significantly less likely to receive cervical cancer screening (P < 0.0001). Despite the launch of an organized cancer screening program in China, cervical cancer screening rates remain alarmingly low and significant variations based on geographical regions and measures of SES still exist. It is therefore essential to adopt strategies to better direct limited available public resources to priority groups.

Hybrid marriages and phenotypic heterosis in offspring: Evidence from China

In genetics, heterosis refers to the phenomenon that cross-breeding within species leads to offspring that are genetically fitter than their parents and exhibit improved phenotypic characteristics. Based on the theory of heterosis and existing genetic evidence, offspring of “hybrid” marriages (spouses originating from different states/provinces/countries/areas), though relatively rare due to physical boundaries, may exhibit greater genetic fitness in terms of intelligence, height, or physical attractiveness (the “distance-performance” hypothesis). This study explores whether heterosis is a contributing factor to offspring’s educational attainment in China by applying a high-dimensional fixed effects (HDFE) modelling framework to the unique 0.1% micro-sample of the 2000 Chinese Population Census data. Concerning potential endogeneity of hybrid marriages, we conduct a series of robustness checks. Reassuringly, the estimated heterosis effect remains significantly positive across various measurements, after controlling for parental educational attainments/height, environmental influences, and over a thousand region and region-by-year fixed effects. The effects in male and higher-educated offspring are found to be stronger. Results are replicated when analyzing body height using data from the China Health and Nutrition Survey. Although endogeneity of “hybrid marriages” may not be completely ruled out, the current study sheds light on the potentially beneficial effects of interprovincial migration on population-level human capital accumulation, and we hope that this paper can intrigue future studies that further address endogeneity. The implied heterosis effect could, therefore, be profound for Homo sapiens as a species from an evolutionary point of view. An additional important implication is that the overall genetic influences of parents on offspring’s performance may be further decomposed into a conventional heredity effect and a heterosis effect that has been neglected previously.